低剂量艾司氯胺酮对甲状腺切除术后苏醒期气管导管呛咳反应的影响  

Effect of low dose s-ketamine on response to tracheal tube cough during anesthesia recovery in patients undergoing thyroidectomy

作　　者：郝玉娟 胡胜红[2] 王胜斌[2] 居霞[2] 张野[1] HAO Yujuan;HU Shenghong;WANG Shengbin;JU Xia;ZHANG Ye(Department of Anesthesia and Perioperative Medicine,the Second Hospital of Anhui Medical University,Hefei 241003,China;Department of Anesthesia,Affiliate Anqing Hospital of Anhui Medical University,Anqing 246003,China;不详)

机构地区：[1]安徽医科大学附属第二医院麻醉与围术期医学科,合肥241003 [2]安徽医科大学附属安庆医院麻醉科,安徽安庆246003

出　　处：《实用医学杂志》2021年第21期2791-2794,共4页The Journal of Practical Medicine

基　　金：安徽省面上科技攻关项目(编号:1704a0802165)。

摘　　要：目的评估低剂量艾司氯胺酮对甲状腺切除术后苏醒期气管导管呛咳反应的影响。方法选取2020年12月至2021年3月在全身麻醉下行甲状腺切除术的患者66例,随机分为艾司氯胺酮组(n=33)和对照组(n=33)。艾司氯胺酮组于手术结束前30 min静脉滴注0.25 mg/kg艾司氯胺酮,对照组手术结束前30 min滴注等容量生理盐水。记录全麻苏醒期呛咳发生率和呛咳程度,同时记录患者苏醒情况和拔管时的血流动力学变化以及术后第1、2天引流量。结果与对照组比较,艾司氯胺酮组患者全麻苏醒期呛咳发生率、呛咳程度明显降低(P <0.05),艾司氯胺酮组术后第1天、第2天引流量显著少于对照组,且艾司氯胺酮组苏醒期患者的平均动脉压和心率低于对照组(P <0.05);与对照组比较,艾司氯胺酮组患者的睁眼时间和拔管时间无明显变化。结论低剂量艾司氯胺酮能显著降低甲状腺切除术患者麻醉苏醒期的呛咳反应,降低术后渗血量,且无严重不良反应。Objective To evaluate the effect of low dose s-ketamine on response to tracheal tube cough during recovery period from anesthesia after thyroidectomy. Methods Sixty-six patients aged 18~65 years,21 males and 45 females,with BMI 18~25 kg/m2,ASAⅠ-Ⅱ,for selective thyroidectomy under intravenous general anesthesia from December 2020 to March 2021,were randomly divided into group S(n = 33)and group C(n = 33).At 30 min before the end of operation,Group S was injected with 0.25 mg/kg s-ketamine intravenously,and group C was administered by intravenous injection with constant volume saline. The two groups were compared in terms of the incidence and severity of coughing during the recovery period from general anesthesia,anesthesia recovery profiles,hemodynamic changes during extubation and volume of drainage at the first day and the second day after surgery. Results Compared with group C,the incidence and grade of coughing were significantly decreased during the recovery period from anesthesia in group S(P < 0.05),the drainage′ volume at the first day and the second day after surgery in group S was significantly less than that in group C. The mean arterial pressure and heart rate in group S during recovery period from anesthesia were significantly lower than those in group C(P < 0.05). Compared with group C,the changes in the eye-opening time and extubation time of group S were not obvious. Conclusion Low dose s-ketamine can significantly reduce the incidence of coughing and postoperative blood loss in patients with thyroidectomy during anesthesia recovery,even free from severe complications.

关 键 词：艾司氯胺酮 甲状腺 呛咳 

分 类 号：R614[医药卫生—麻醉学]